Provider Demographics
NPI:1982221156
Name:EDMONDSON, CHRISTOPHER LEE (APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:LEE
Last Name:EDMONDSON
Suffix:
Gender:M
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 NE FOX TRAIL DR
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64014-1779
Mailing Address - Country:US
Mailing Address - Phone:816-215-5790
Mailing Address - Fax:
Practice Address - Street 1:104 NW STATE ROUTE 7 STE B
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64014-2749
Practice Address - Country:US
Practice Address - Phone:816-229-8880
Practice Address - Fax:816-229-4363
Is Sole Proprietor?:No
Enumeration Date:2020-07-02
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020019954363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily